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Mulders G, Uitslager N, Kavanagh M, Birkedal MF, Nicolo G, Fenton R, Westesson LM. The role of the specialist nurse in comprehensive care for bleeding disorders in Europe: An integrative review. Haemophilia 2024; 30:598-608. [PMID: 38439128 DOI: 10.1111/hae.14974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 02/12/2024] [Accepted: 02/13/2024] [Indexed: 03/06/2024]
Abstract
INTRODUCTION Managing bleeding disorders (BDs) is complex, requiring a comprehensive approach coordinated by a multidisciplinary team (MDT). Haemophilia nurses (HNs) play a central role in the MDT, frequently coordinating care. As novel treatments bring change to the treatment landscape, ongoing education and development is key. However, understanding of the roles and tasks of HNs is lacking. AIM The EAHAD Nurses Committee sought to identify and describe the roles and tasks of the European HN. METHODS A five-step integrative review was undertaken, including problem identification, literature search, data evaluation, data synthesis and presentation. Relevant literature published from 2000 to 2022 was identified through database, hand and ancestry searching. Data were captured using extraction forms and thematically analysed. RESULTS Seven hundred and seventy-seven articles were identified; 43 were included. Five main roles were identified, with varied and overlapping associated tasks: Educator, Coordinator, Supporter, Treater and Researcher. Tasks related to education, coordination and support were most frequently described. Patient education was often 'nurse-led', though education and coordination roles concerned both patients and health care practitioners (HCPs), within and beyond the MDT. The HN coordinates care and facilitates communication. Long-term patient care relationships place HNs in a unique position to provide support. Guidelines for HN core competencies have been developed in some countries, but autonomy and practice vary. CONCLUSION As the treatment landscape changes, all five main HN roles will be impacted. Despite national variations, this review provides a baseline to anticipate educational needs to enable HNs to continue to fulfil their role.
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Affiliation(s)
- Greta Mulders
- Department of Hematology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Nanda Uitslager
- Center for Benign Haematology, Thrombosis and Haemostasis, Van Creveldkliniek, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Mary Kavanagh
- Children's Coagulation Centre, Children's Health Ireland, Dublin, Ireland
| | | | - Gabriella Nicolo
- Angelo Bianchi Bonomi Haemophilia and Trombosis Center, Milan, Italy
| | | | - Linda Myrin Westesson
- Department of Medicine, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
- Sahlgrenska Academy, Institution for Nursing Science and Health at Gothenburg University, Gothenburg, Sweden
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Liptrott S, NíChonghaile M, O’Connell L, Aerts E. The Evolving Role of Haematology Nursing Practice: A Cross-Sectional Survey. Mediterr J Hematol Infect Dis 2023; 15:e2023033. [PMID: 37180205 PMCID: PMC10171204 DOI: 10.4084/mjhid.2023.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 04/20/2023] [Indexed: 05/16/2023] Open
Abstract
Background And Objectives The scope of haematology nursing practice is dynamic and must respond to advances in treatment, patients' needs and service requirements. Little is known, however, about the different roles of haematology nurses across the European setting. The purpose of this study was to identify the professional practices of haematology nurses. Method A cross-sectional online survey design was used to investigate practice elements undertaken by haematology nurses. Frequencies and descriptive statistics were calculated for demographic variables and chi-square tests to examine relationships between practice elements, nursing role and country. Results Data is reported from 233 nurses across 19 countries, working as Staff Nurses (52.4%), senior nurses (12.9%) and Advanced Practice Nurses (APNs) (34.8%). Most frequently reported activities included medication administration - oral/ intravenous (90.0%), monoclonal antibodies (83.8%), chemotherapy (80.6%), and blood components (81.4%). APNs were more commonly involved in nurse-led clinics and prescribing activities (p < .001, p = .001, respectively); however, other nursing groups also reported performing extended practice activities. Patient and carer education was a significant part of all nurses' roles; however, senior nurses and APNs were more often involved with the multidisciplinary team (p < .001) and managerial responsibilities (p < .001). Nurses' involvement in research was limited (36.3%) and frequently reported as an out-of-work hours activity. Conclusions This study describes haematology nursing care activities performed in various contexts and within different nursing roles. It provides further evidence of nursing activity and may contribute to a core skills framework for haematology nurses.
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Affiliation(s)
- Sarah Liptrott
- Nursing Development and Research Unit, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), via Gallino 12, 6500, Bellinzona, Switzerland
- Department of Nursing, Regional Hospital of Bellinzona e Valli, Ente Ospedaliero Cantonale (EOC), via Gallino 12, 6500, Bellinzona, Switzerland
- on behalf of the Haematology Nurses and Healthcare Professionals Group (HNHCP)
| | - Mairéad NíChonghaile
- HOPE Directorate, St James’s Hospital, Dublin 8, Ireland
- on behalf of the Haematology Nurses and Healthcare Professionals Group (HNHCP)
| | - Liz O’Connell
- Haematology Department, Tallaght University Hospital, Dublin 24, Ireland
- on behalf of the Haematology Nurses and Healthcare Professionals Group (HNHCP)
| | - Erik Aerts
- Department of Internal Medicine, Haematology, University Hospital Zurich, Rämistrasse 100, CH-8091 Zurich, Switzerland
- on behalf of the Haematology Nurses and Healthcare Professionals Group (HNHCP)
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Arnall JR, Moore DC, Michael M, Wolcott M, Cowgill N. Measuring the Impact of a Pharmacist-Driven Blood Factor Education Program: A Prospective, Single-Center Observational Study. Hosp Pharm 2022; 58:282-288. [DOI: 10.1177/00185787221137901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Introduction: Patients with bleeding disorders are best served by multidisciplinary teams. Pharmacists can play a critical role in the optimal management of patients with bleeding disorders through blood factor stewardship strategies and programs. An educational program was developed and implemented wherein a hematology pharmacist provided brief recorded lectures to an entire department of pharmacists in a multi-site health-system with the goal to improve the knowledge base and confidence among this population of general practitioners. Methods: The primary objective of this study was to evaluate the educational outcomes of a blood factor education program for pharmacists. The impact of the educational program was determined by measuring the difference in mean test scores between the pre- and post-program surveys. Results: The final analysis included 214 participants. The primary endpoint of mean competency test score was significantly improved in the post-test compared to pre-test (78.33% vs 52.83%; P < .0001). Any degree of test score improvement was observed in 99% ( n = 212) of participants. Pharmacist confidence was significantly improved in all 20 domains of bleeding disorders and blood factor product verification and management. Conclusion: This program identified that most pharmacists in a large multi-site health-system were not familiar with bleeding disorders to a satisfactory degree, commonly because of the relative rare encounters with bleeding disorder-related orders, and that despite systems-based support there was an opportunity to improve practice through education. Such educational programming could be beneficial for the development of pharmacist-provided care and is a measure that could be implemented as part of blood factor stewardship initiatives.
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Affiliation(s)
- Justin R Arnall
- Specialty Pharmacy Servivce, Atrium Health, Charlotte, NC, USA
| | - Donald C Moore
- Levine Cancer Institute, Atrium Health, Concord, NC, USA
| | - Meghan Michael
- Specialty Pharmacy Servivce, Atrium Health, Charlotte, NC, USA
| | - Michael Wolcott
- High Point University Fred Wilson School of Pharmacy, High Point, NC, USA
| | - Nicole Cowgill
- Specialty Pharmacy Servivce, Atrium Health, Charlotte, NC, USA
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Ballmann J, Ewers M. Nurse-led education of people with bleeding disorders and their caregivers: A scoping review. Haemophilia 2022; 28:e153-e163. [PMID: 35850204 DOI: 10.1111/hae.14629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 06/28/2022] [Accepted: 07/02/2022] [Indexed: 01/19/2023]
Abstract
INTRODUCTION People with bleeding disorders (PwBd) and their caregivers face many challenges in developing viable self-management strategies for living with the condition. Nurse-led education can support them to overcome these challenges. However, it is often unclear what educational needs are addressed, how nurses educate PwBd and what didactic concepts they follow. AIM To gain deeper insights into nurse-led patient education in haemophilia care and provide a basis for a more systematic and evidence-based approach to this task. METHODS A scoping review methodology was used. A systematic search for relevant publications on this topic was conducted in various databases between November 2020 and April 2021. Data sets were analysed following the PRISMA-ScR-checklist and using content analysis. RESULTS Of 588 studies identified, 23 sources of evidence met the inclusion criteria. The educational needs of PwBd and their families are extensive, multifaceted, and variable but rarely assessed systematically. These needs were met at certain times throughout their lifetimes. Nurse-led education differed in content, duration, and modality, including interventions such as information, consultation and instruction. An improvement in treatment-oriented self-management and self-efficacy was the most reported outcome. The didactic concepts on which the educational interventions were based were rarely specified. CONCLUSIONS There is a lack of systematic approaches in assessing and addressing the educational needs of PwBd and their caregivers. High variability was found in the literature regarding nurse-led patient education in haemophilia care. This suggests that more research is needed on this topic - not least on the interventions' conceptual foundations and impact models.
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Affiliation(s)
- Julia Ballmann
- Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Institute of Health and Nursing Science, Berlin, Germany
| | - Michael Ewers
- Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Institute of Health and Nursing Science, Berlin, Germany
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Guelcher CJ, Chase J, Pollard D. Women and girls with heavy menstrual bleeding and inherited bleeding disorders: A call to action for the Haemophilia Treatment Centre Nurse. Haemophilia 2020; 27 Suppl 3:82-86. [PMID: 32469119 DOI: 10.1111/hae.14019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 04/09/2020] [Indexed: 12/27/2022]
Abstract
Over the last several decades, the increasing focus on women with inherited bleeding disorders (WBD) has brought more patients into Haemophilia Treatment Centres (HTC) around the world. These women present with unique challenges including a significant risk of heavy menstrual bleeding (HMB). The influx of a new patient group has necessitated expansion of the services provided by the multi-disciplinary team in HTCs. Nurses already play a central role in patient and family education within the HTC. As such, they are well positioned to participate in the development of adaptations within the HTC infrastructure to provide clinical care and education specifically for WBD. The nursing experts in HTCs should play an active role in outreach as well as providing education to WBD. Despite this supposition, review of the growing body of literature surrounding the topic of WBD is notable for a paucity of literature highlighting the role of the HTC nurse and potential impact on this, relatively new, but steadily increasing, patient population.
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Affiliation(s)
| | - Jaime Chase
- John Hunter Children's Hospital, New Lambton Heights, NSW, Australia
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de Morais Costa NC, Costa ÍM, Guimarães TMR, de Souza HP, Casaretto ES, de Medeiros TC, Barbosa SM, Matos AIEL, Oliveira EG, Camelo RM. North-eastern Brazilian recommendations for the nurse professional role on the pharmacokinetic-assisted prophylaxis individualization for haemophilia A. Haemophilia 2020; 26:e120-e123. [PMID: 32026514 DOI: 10.1111/hae.13934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 01/13/2020] [Accepted: 01/14/2020] [Indexed: 06/10/2023]
Affiliation(s)
| | - Íris Maciel Costa
- Fundação de Hematologia e Hemoterapia de Pernambuco (HEMOPE), Recife, Brazil
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Pollard D, Harrison C, Dodgson S, Holland M, Khair K. The UK haemophilia specialist nurse: Competencies fit for practice in the 21st century. Haemophilia 2020; 26:622-630. [PMID: 32311205 PMCID: PMC7496226 DOI: 10.1111/hae.14002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 02/25/2020] [Accepted: 03/27/2020] [Indexed: 11/30/2022]
Abstract
Introduction Nurses play a central co‐ordinating role in delivering comprehensive care for people with haemophilia and allied bleeding disorders, for which they need a broad range of competencies. The UK Haemophilia Nurses Association (HNA) published a role description in 1994 which was developed into a competency framework in 2014. This has now been updated to reflect current educational and clinical practice. Aim To summarize the evidence supporting the nurse's advanced role within haemophilia care and develop new competencies to deliver comprehensive care within a multidisciplinary team. Methods Systematic reviews were identified by PubMed literature search. The HNA conducted workshops to consult its membership, and the authors incorporated this input to update its competency framework within the structure outlined by Health Education England in multiprofessional framework for advanced clinical practice in England (2017). Results The proposed framework includes five domains (Clinical knowledge, Clinical/direct care, Communication and support, Collaborative practice and Research) supported by indicators for four levels of practice (beginner, competent, proficient and expert). The framework is a tool which nurses and their managers can use to assess skills and knowledge, and identify learning needs appropriate to personal development and improve patient care and outcomes. Conclusion The HNA has developed a new competency framework to provide a strong foundation for haemophilia specialist nurses to continue improving services for people living with bleeding disorders and their families, as well as supporting personal development alongside new therapeutic options, models of care and follow‐up.
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Affiliation(s)
- Debra Pollard
- Katharine Dormandy Haemophilia and Thrombosis Centre, Royal Free Hospital NHS Foundation Trust, London, UK
| | - Catherine Harrison
- Sheffield haemophilia and Thrombosis Centre, Royal Hallamshire Hospital, Sheffield, UK
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Khair K, Pelentsov L. Assessing the supportive care needs of parents with a child with a bleeding disorder using the Parental Needs Scale for Rare Diseases (PNS‐RD): A single‐centre pilot study. Haemophilia 2019; 25:831-837. [DOI: 10.1111/hae.13826] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 06/26/2019] [Accepted: 06/26/2019] [Indexed: 01/02/2023]
Affiliation(s)
- Kate Khair
- Centre for Outcomes and Experience Research in Childhood Health, Illness and Disability (ORCHID) London UK
- Haemophilia Centre Great Ormond Street Hospital for Children NHS Foundation Trust London UK
| | - Lemuel Pelentsov
- School of Nursing and Midwifery University of South Australia Adelaide South Australia Australia
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9
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Lazure P, Munn J, Labbé S, Murray S, Butler R, Khair K, Lambing A, Malone M, Reiser T, Newall F. Education needs of nurses in thrombosis and hemostasis: An international, mixed-methods study. Res Pract Thromb Haemost 2019; 3:99-108. [PMID: 30656282 PMCID: PMC6332710 DOI: 10.1002/rth2.12155] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 09/07/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The need for a more integrated, multidisciplinary approach to care for individuals with bleeding or clotting disorders has been highlighted in recent years. Evidence-based education adapted to nurses' needs is essential for a successful evolution. However, limited data currently exist on the clinical challenges nurses face in this specialty area. OBJECTIVES Identify barriers and challenges faced by specialty nurses, and determine possible causes, to develop appropriate educational interventions. METHODS A mixed-methods study, combining qualitative (semi-structured interviews) and quantitative (online survey) data was conducted on the challenges experienced by hemostasis nurses in nine countries (Argentina, Australia, Canada, China, France, Germany, Spain, the UK, and the US), and deployed in five languages (English, French, German, Mandarin, and Spanish). Qualitative data were analyzed using thematic analysis. Quantitative data were analyzed using frequency tables, chi-squares and standard deviations. RESULTS Participants (n = 234) included nurses (n = 212; n = 22 qualitative; n = 190 quantitative); and patients receiving care for bleeding or clotting conditions or their caretakers (n = 22 qualitative phase only). Through triangulated data analysis, six challenging areas emerged: (a) Understanding of von Willebrand disease (VWD); (b) Anticoagulant safety profile in specific patients; (c) Understanding the treatment of patients with inhibitors; (d) Patient risk assessments; (e) Individualization of care and communication with patients; and (f) Accessing and implementing relevant professional education. CONCLUSIONS This needs assessment provides a comprehensive illustration of the current challenges faced by nurses in the field of bleeding and clotting disorders, and indicates where gaps in skills, knowledge or confidence would benefit from nurse-specific educational programming.
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Affiliation(s)
| | - James Munn
- University of MichiganAnn ArborMichiganUSA
| | | | | | - Regina Butler
- Division of Hematology, Hemostasis and Thrombosis CenterChildren's Hospital of Philadelphia (CHOP)PhiladelphiaPennsylvania , USA
| | - Kate Khair
- Department of HaemophiliaGreat Ormond Street Hospital for ChildrenNHS TrustLondonUK
| | | | - Maura Malone
- Hemophilia and ThrombosisDartmouth‐Hitchcock USALebanonNew HampshireUSA
| | - Thomas Reiser
- International Society on Thrombosis and HaemostasisCarrboroNorth CarolinaUSA
| | - Fiona Newall
- Nursing ResearchRoyal Children's HospitalMelbourneVictoriaAustralia
- Department of Clinical HaematologyRoyal Children's HospitalMelbourneAustralia
- Department of Nursing and Department of Paediatricsthe University of MelbourneMelbourneAustralia
- Haematology Research GroupMurdoch Children's Research InstituteMelbourneAustralia
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Chen Y, He Y, Zhou X, Xu Y, Zhang B, Liu Y, Weng X. Application of optimized nursing process to perioperative patients with haemophilic pseudotumours. Haemophilia 2018; 24:e375-e378. [PMID: 30088316 DOI: 10.1111/hae.13592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Accepted: 06/26/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Yaping Chen
- Department of Orthopaedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yu He
- Department of Orthopaedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xi Zhou
- Department of Orthopaedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yuan Xu
- Department of Orthopaedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Baozhong Zhang
- Department of Orthopaedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yong Liu
- Department of Orthopaedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xisheng Weng
- Department of Orthopaedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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Stoffman J, Andersson NG, Branchford B, Batt K, D'Oiron R, Escuriola Ettingshausen C, Hart DP, Jiménez Yuste V, Kavakli K, Mancuso ME, Nogami K, Ramírez C, Wu R. Common themes and challenges in hemophilia care: a multinational perspective. ACTA ACUST UNITED AC 2018; 24:39-48. [PMID: 30073913 DOI: 10.1080/10245332.2018.1505225] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To identify ways that provision of hemophilia care can be maximized at the local level, irrespective of available resources or cultural or geographic challenges. METHODS The SHIELD group used its multinational experience to share examples of local initiatives that have been employed to deliver optimal hemophilia care. RESULTS The examples were reviewed and categorized into four key themes: guidelines and algorithms for delivery of care; collaboration with patients and allied groups for care and education; registries for the monitoring of treatment and outcomes and health care planning and delivery; and opportunities for personalization of care. These themes were then incorporated into a road map for collaborative care in hemophilia that reflected the contribution of best practice. DISCUSSION Differing healthcare reimbursement systems, budgetary constraints, and geographical and cultural factors make it difficult for any country to fully deliver ideal care for people with hemophilia. The SHIELD approach for collaborative care provides illustrative examples of how four key themes can be used to optimize hemophilia care in any setting. ABBREVIATIONS AHCDC: Association of Hemophilia Clinic Directors of Canada; AICE: Italian Association of Hemophilia Centres; ATHN: American Thrombosis and Hemostasis Network; EAHAD: European Association for Haemophilia and Allied Disorders; EHC: European Hemophilia Consortium; FIX: Coagulation Factor IX; FVIII: Coagulation Factor VIII; HAL: Haemophilia Activity List; HJHS: Haemophilia Joint Health Score; HTC: Hemophilia Treatment Centre; HTCCNC: Hemophilia Treatment Centre Collaborative Network of China; MASAC: Medical and Scientific Advisory Council; MDT: Multidisciplinary team; NHD: National Haemophilia Database; NHF: National Hemophilia Foundation; PK: Pharmacokinetics; POCUS: Point of care ultrasound; PWH: People with haemophilia; SHIELD: Supporting Hemophilia through International Education, Learning and Development; WFH: World Federation of Hemophilia.
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Affiliation(s)
- J Stoffman
- a Department of Pediatrics and Child Health , University of Manitoba , Winnipeg , Canada
| | - N G Andersson
- b Department for Thrombosis and Haemostasis Hematology , Skåne University Hospital , Scania , Sweden
| | - B Branchford
- c School of Medicine Research Complex 1 , University of Colorado , Aurora , CO , USA
| | - K Batt
- d Wake Forest Baptist University Medical Center, 1 Medical Center Blvd , Winston-Salem , NC , USA
| | - R D'Oiron
- e Centre de Traitement de l'Hémophilie et Maladies Hémorragiques Constitutionnelles Rares , Hôpitaux Universitaires Paris Sud - Hôpital Bicêtre , Le Kremlin-Bicêtre Cedex , France
| | | | - D P Hart
- g The Royal London Hospital Haemophilia Centre , Barts and The London School of Medicine & Dentistry , London , UK
| | - V Jiménez Yuste
- h Hospital Universitario La Paz - Hematology , Madrid , Spain
| | - K Kavakli
- i Department of Hematology , Ege University Children's Hospital , Izmir , Turkey
| | - M E Mancuso
- j Angelo Bianchi Bonomi Haemophilia and Thrombosis Centre , University of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico and University of Milan , Milan , Italy
| | - K Nogami
- k Department Pediatrics , Nara Medical University , Kashihara, Nara , Japan
| | - C Ramírez
- l Clinica Colsanitas , Fundación Universitaria Sanitas , Bogota , Colombia
| | - R Wu
- m Hemophilia Work Group, Hematology-Oncology Center , Beijing Children's Hospital affiliated to Capital Medical University , Beijing , People's Republic of China
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Giangrande PLF, Hermans C, O'Mahony B, de Kleijn P, Bedford M, Batorova A, Blatný J, Jansone K. European principles of inhibitor management in patients with haemophilia. Orphanet J Rare Dis 2018; 13:66. [PMID: 29703220 PMCID: PMC5921290 DOI: 10.1186/s13023-018-0800-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 04/06/2018] [Indexed: 12/11/2022] Open
Abstract
Background In spite of recent major advances in the understanding and treatment of inhibitor development in patients with haemophilia, multidisciplinary management of many of these patients remains suboptimal and highly heterogenous across Europe. Methods Following a series of multidisciplinary meetings and a review of the literature, the European haemophilia community of health professionals and patients jointly defined practical optimum standards for ensuring and harmonizing treatment and care for patients with an inhibitor. Results Ten complementary principles for the management of inhibitors in haemophilia have been developed, emphasizing the importance and benefits of a centralized, multidisciplinary, expert and holistic approach. Conclusions This document will serve as a benchmark to improve the multidisciplinary and practical management of patients with inhibitor. Implementation and adherence to each of these principles should have a major positive impact on the management and outcomes of patients developing an inhibitor.
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Affiliation(s)
- P L F Giangrande
- European Haemophilia Consortium, Rue de l'Industrie, B-1000, Brussels, Belgium. .,University of Oxford, Oxford, UK.
| | - C Hermans
- Haemostasis and Thrombosis Unit, Division of Haematology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - B O'Mahony
- European Haemophilia Consortium, Rue de l'Industrie, B-1000, Brussels, Belgium.,Trinity College, Dublin, Ireland
| | - P de Kleijn
- Department of Rehabilitation, Nursing Science and Sports, University Medical Center Utrecht, Utrecht, The Netherlands
| | - M Bedford
- Canterbury Christ Church University, Kent, UK
| | - A Batorova
- National Hemophilia Center, Department of Hematology and Transfusion Medicine, School of Medicine of Comenius University and University Hospital, Bratislava, Slovakia
| | - J Blatný
- Children's University Hospital Brno, Brno, Czech Republic
| | - K Jansone
- European Haemophilia Consortium, Rue de l'Industrie, B-1000, Brussels, Belgium
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13
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Santaella ME, Bloomberg M, Anglade D. Home infusion teaching practices at federally funded hemophilia treatment centers in the United States of America. Res Pract Thromb Haemost 2017; 1:81-89. [PMID: 30046677 PMCID: PMC6058201 DOI: 10.1002/rth2.12020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 05/16/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Home management of hemophilia is standard of care in many countries. This study examined current nursing practices in teaching home infusion (HI) at hemophilia treatment centers (HTC) in the USA. OBJECTIVES The aims were to identify and compare tools and resources used, areas of unmet needs, and to discuss implications for nurses in practice. METHODS An anonymous electronic survey was distributed to 574 HTC nurses; 156 responses were analyzed. RESULTS The data demonstrated that nurses, more specifically nurse coordinators, were most responsible for teaching HI. However, many nurses lack the knowledge and confidence to do so: 23.0% responded feeling somewhat or not very confident with teaching. Of those 36.4% were staff nurses, 11.9% nurse coordinators, and 41.7% advanced practice registered nurses. The majority of nurses have worked more than 5 years as a nurse, with a mean length of time of 23.7 years (SD=11.12, range 3-47) and a mean of 12.9 years (SD=10.29, range 1-42) in a HTC. Thirty-eight and a half percent of nurses have worked less than 5 years in a HTC. Most nurses appeared to follow the Infusion Nurses Society standards when performing venipunctures. Many centers reported using a formal tool or curriculum to teach HI. Nonetheless, these curricula are not uniform and their use is inconsistent between centers and regions. CONCLUSION There are currently no national guidelines or standards to assist nurses in this task. The data confirmed the need to develop guidelines and a standardized curriculum to teach HI.
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Affiliation(s)
| | - Maya Bloomberg
- University of Miami Hemophilia Treatment CenterMiamiFLUSA
| | - Debbie Anglade
- University of Miami School of Nursing & Health SciencesCoral GablesFLUSA
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